We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed, a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here. #1: Honey…or Jam for Button Battery Ingestion? Spoon Feed This pig cadaver study argues that jam is a reasonable alternative (if honey and sucralfate are unavailable) to give patients while awaiting definitive endoscopic removal after button battery ingestion. Source Home Therapies to Neutralize Button Battery Injury in ..read more

Authors: Tony Spadaro MD MPH (@Tspadaro91, Medical Toxicology-Addiction Medicine Fellow, Rutgers New Jersey Medical School/New Jersey Poison Information and Education System); Howard A. Greller (Associate Professor of EM, Medical Toxicology Program Director, Rutgers New Jersey Medical School/New Jersey Poison Information and Education System); Corey Hazekamp MD (@coreyhazekamp, Emergency Medicine Resident, Lincoln Hospital) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK ..read more

Today on the emDOCs cast with Brit Long, MD (@long_brit), we cover acute chest syndrome part 1. Episode 100: Acute Chest Syndrome Part 1   Background SCD is an autosomal recessive condition that results in the formation of hemoglobin S (HbS). HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs. Other causes of sickling:  acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, i ..read more

Authors: Ernesto Hernandez, MD (EM Resident Physician, Advocate Christ Medical Center, Oak Lawn, IL); Jennifer Woodruff, MD (EM Attending Physician, Advocate Christ Medical Center, Oak Lawn, IL) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics. We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a ..read more

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits, a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives. If you have a story to share click here. Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights A healthy 24-year-old dies of a brain abscess  What was missed? Was it negligence?   Facts: A 24-year-old ma ..read more

Authors: Kriti Gupta, MD (Pediatric Emergency Medicine Fellow, NewYork-Presbyterian Brooklyn Methodist Hospital, Division of Pediatric Emergency Medicine, Department of Emergency Medicine); Nessy Dahan, MD (Pediatric Emergency Medicine Attending Physician, Emergency Ultrasound Faculty, Division of Pediatric Emergency Medicine, Division of Emergency Ultrasound, Department of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Louis); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit ..read more

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed, a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here. #1: Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations Spoon Feed A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpreta ..read more

Today on the emDOCs cast with Davis Sugar, Jess Pelletier, and Brit Long, we discuss multiple sclerosis. Episode 99: Multiple Sclerosis in the ED   Background: MS is an autoimmune disease affecting oligodendrocytes, the nerve cell responsible for myelinating the axons of neurons. This results in demyelination and axonal loss within the central nervous system (CNS). MS typically affects women age 20-40 years. Risk factors include northern latitudes, vitamin D deficiency, EBV infection, smoking, genetics, and concomitant autoimmune diseases.   Presentation Most initially present w ..read more

Authors: Russ Burgin (MS4, Bethesda, MD); Rachel Bridwell, MD (EM Attending Physician, WA) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics. We’ll keep it short, while you keep that EM brain sharp. A 68-year-old male with a history of poorly controlled diabetes presents to the ED with increasing right-sided ear and facial pain ..read more

Authors: Joseph R. Peters, DO, RDMS, FACOEP, FACEP, FACOI (EM Attending Physician, OSF St. Francis Medical Center); Carolina Hartje, DO (EM Resident Physician, OSF St. Francis Medical Center) // Reviewed by: Stephen Alerhand, MD; Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Introduction There are an estimated 300,000-600,000 Americans who develop venous thromboembolisms (VTE) each year, including deep venous thromboembolisms (DVT) and pulmonary embolism (PE).1-3 VTE is responsible for hospitalizing over 250,000 Americans every year, and there are an estimated 100,000 deaths annuall ..read more